“What’s Going On!” Marvin Gaye’s Commentary on Healthcare

We did not have an “AHA” moment. You must read my previous blog (AHA!) to grasp the context. But there are a few things we discovered. Let’s start with the obvious. Healthcare is complex. There are several options and constituencies to grapple with. If you want details on what was proposed, again, refer to my previous blog. The question is, “What’s Going On” with healthcare. . . now?

We read all the headlines about the failed effort to repeal and replace. Some of us rejoiced, others lamented. Regardless of your political ideology we agree our healthcare industry is crippled in our country. Lawmakers have an obligation to do something to improve the choices that are available. In some counties, here in Texas there is only one insurance company on the exchange. That is contrary to an objective of the law, which was to provide choices.

Secretary Tom Price, MD was asked in an Appropriations meeting what steps HHS was going to take considering the defeat of the American Healthcare Act. His responses were telling. It is obvious he did not wish to say anything that would further destabilize the insurance markets.

Mandate remains. That’s right! Don’t mistake the excitement. I am not in favor of the government taking my hard-earned dollars. However, I am in favor of sensible means to encourage people to take care of their responsibility. Love it or hate it the penalty encourages people who would not otherwise purchase insurance. And for the obstinate, dollars are collected to pay the bills for those who cannot pay or neglected to pay.

What about the money? Will the government continue to fund the subsidies you ask? In a word, yes. When asked regarding the subsidies Secretary Price expressed concerns about destabilizing the market. He also mentioned that more insurers would leave the market if the federal funding was not in place. In fact, the CEO of Molina said that premiums would rise by at least 25% if the government did not fund the program.

Cheaper Prices. One potential “good” thing is there is a chance the insurers would be allowed greater flexibility in the kinds of plans they can offer. Remember “good” is relative. Under current interpretation of the ACA/Obamacare there are ten essential health benefits that every plan must include. Every plan is a comprehensive plan. That is one variable that has driven up the costs of insurance. There is no such thing as a “skinny plan” under the current law.My skinny friends and I quietly take offense. That’s why cheaper, less comprehensive options were phased out after 2010. Secretary Price has said he will determine what is “essential” leaving the door open for lower cost plans, that cover less.

Now if they would just negotiate with the pharmaceutical companies, fund a high-risk pool (sick people insurance), expand Medicaid into the states that haven’t and throw the carriers a bone so they will expand their networks, then we might have a decent system. And if it was that easy it would already be done. In the meantime, let’s keep our ears peeled to be abreast of the situation. “You know we got to find a way. . . to bring some loving here today!”